Routine Brain Screening for People Older Than 70 Recommended

A panel of experts in aging recommends that everyone 70 and older should have their memory and reasoning ability evaluated annually.

This is the first time routine brain health screenings have been recommended for patients starting at age 70, according to members of the panel, which met at Saint Louis University.

Patients found to have cognitive problems also should be screened for physical frailty, and vice versa, the panel added.

“This is an important step toward enhancing brain health for aging populations throughout the world,” said John Morley, M.D., director of geriatric medicine at Saint Louis University and lead author of the consensus paper. “The ability to learn, solve problems, and remember is a key to successful health and aging.”

Published in the Journal of America Medical Directors Association, the recommendation for screenings was spurred by numerous studies that suggest 30 percent of those older than 70 have memory problems. Approximately 16 percent of people in this age group have mild cognitive impairment, while 14 percent have dementia, including Alzheimer’s disease, the panel noted.

Some causes of early cognitive disorders can be reversed and treated when caught early, according to the experts, including depression, hypothyroidism, sleep apnea, problems with sight and hearing, and treatments of multiple health conditions with medications.

“You can actually fix some of these issues, which is one reason why it’s critical to identify a problem and try to find a root cause,” said Morley.

The progression of cognitive impairment can sometimes be slowed through a series of lifestyle changes, according to the panel.

They endorsed changes suggested in FINGER, a Finnish geriatric study published in The Lancet, which found that people who ate a healthy diet, exercised, trained their memories, and managed cardiovascular risks were less likely to develop cognitive decline and memory problems.

“There are things you can do to slow down the progression of not thinking well,” Morley said.

The panel endorsed a Mediterranean-style diet — packed with fruits and vegetables, fish twice a week, olive oil, nuts, legumes, and whole grains — for patients who have early cognitive problems.

And because past research shows brain health, as well as physical well-being, is connected to exercise, they encourage physical exercise, including resistance training and tai chi.

The aging experts also noted that previous studies show that people who dance, engage in intellectual activity, and play a musical instrument have less mental decline than those who not pursue these hobbies. They add that video games can improve reasoning, memory, reaction time, and attention in older adults.

According to the aging experts, it’s important for physicians to know if their patients are not remembering or thinking clearly because they might not be able to follow doctors’ orders for medical problems, such as diabetes or heart disease.

“If you have diabetes and are not thinking as well as the general population, you might forget how to do the required daily finger prick to determine your blood sugar levels, which would compromise your health,” Morley said.

“However, if your doctor knows you have difficulty remembering, someone in his or her office can make sure you understand exactly how to check your glucose levels and give you written instructions as a ready reference. It’s a simple common sense thing that can make a huge difference in your health.”

Finally, for those people whose memory problems likely will worsen, knowing in advance can help them plan for the future, he said. They can begin considering tough questions, such as when to stop driving or remove dangerous tools from their homes, and set up advanced directives for health, financial, and legal matters. They also have time to identify sources of support like family members or friends and organizations such as the Alzheimer’s Association.

“Information is power,” Morley said.

“Our recommendations are going to shape clinical practice in a big way,” Morley said. “Physicians are hungry for this information to help their patients, and as the message gets out, patients will request screenings.”

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About Janice Wood

Janice Wood is a long-time writer and editor who began working at a daily newspaper before graduating from college. She has worked at a variety of newspapers, magazines and websites, covering everything from aviation to finance to healthcare.